Simple diagnostic tests to detect toxic alcohol intoxications.
Methanol, ethylene glycol, and diethylene glycol intoxications can produce visual disturbances, neurologic disturbances, acute renal failure, pulmonary dysfunction, cardiac dysfunction, metabolic acidosis, and death. Metabolic acidosis and an increased serum osmolality are important clues to their diagnosis. The former reflects the organic acids produced by metabolism of the parent alcohol, whereas the latter is caused by accumulation of the offending alcohol. However, neither the clinical nor the laboratory findings are specific for toxic alcohol ingestions. The definitive diagnosis of the alcohol intoxications is commonly based on detection of the alcohol or its metabolites in blood. Early diagnosis is important, because initiation of appropriate treatment can markedly decrease their rates of morbidity and mortality. Currently, detection of the parent alcohol in body fluids is inferred from its measurement in blood. This measurement is often performed by specialty laboratories using expensive equipment, and a long delay between obtaining the specimen and getting the results is not unusual. In this report, we describe liquid-based tests that detect methanol, ethylene glycol, diethylene glycol, and ethanol in saliva. The tests are sensitive, and they have different specificity for each of the alcohols facilitating distinction among them. The relatively high sensitivity and specificity of the tests as a whole will facilitate the rapid diagnosis of each of these alcohol intoxications.
Shin
Jai Moo
JM
Medical and Research Services VHAGLA Healthcare System, UCLA Membrane Biology Laboratory, Division of Nephrology VHAGLA Healthcare System and David Geffen School of Medicine, Los Angeles, CA, USA.
Sachs
George
G
Kraut
Jeffrey A
JA
D019840:2-Propanol / Q000032:analysis / Q000737:chemistry; D000426:Alcohol Dehydrogenase / Q000737:chemistry; D000429:Alcohol Oxidoreductases / Q000737:chemistry; D000435:Alcoholic Intoxication / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D000431:Ethanol / Q000032:analysis* / Q000737:chemistry; D019855:Ethylene Glycol / Q000032:analysis / Q000737:chemistry; D005026:Ethylene Glycols / Q000032:analysis / Q000737:chemistry; D006801:Humans; D000432:Methanol / Q000032:analysis / Q000737:chemistry; D010504:Periodic Acid / Q000737:chemistry; D010756:Phosphoric Acids / Q000737:chemistry; D011196:Potassium Permanganate / Q000737:chemistry; D012463:Saliva / Q000737:chemistry*
D005026:Ethylene Glycols; D010756:Phosphoric Acids; D011196:Potassium Permanganate; D010504:Periodic Acid; D000431:Ethanol; C013484:diethylene glycol; C009288:metaperiodate; C030242:phosphoric acid; D000429:Alcohol Oxidoreductases; D000426:Alcohol Dehydrogenase; C019643:alcohol oxidase; D019855:Ethylene Glycol; D019840:2-Propanol; D000432:Methanol